HIV

1,2

A patient diagnosed with acquired immunodeficiency syndrome (AIDS) comes to the clinic to find out which tests would determine the prognosis of the syndrome. What information will the nurse provide? Select all that apply. 1 Prognosis can be assessed by viral load. 2 Prognosis can be assessed by CD4 +T-cell count. 3 Prognosis can be assessed by red blood cell count. 4 Prognosis can be assessed by testing for hepatitis B virus (HBV). 5 Prognosis can be assessed by immunoglobulin M (IgM) antibody levels

2

A patient has been diagnosed with human immunodeficiency virus (HIV). The patient does not want to take more than one antiretroviral drug. What explanation can the nurse give to the patient regarding the importance of combination antiretroviral therapy? 1 Together they will cure HIV 2 Viral replication will be inhibited 3 They will decrease CD4+ T cell counts 4 It will prevent interaction with other drugs

c

A patient informed of a positive rapid antibody test result for human immunodeficiency virus (HIV) is anxious and does not appear to hear what the nurse is saying. What action by the nurse is most important at this time? a. Teach the patient how to reduce risky behaviors. b. Inform the patient about the available treatments. c. Remind the patient about the need to return for retesting to verify the results. d. Ask the patient to identify individuals who had intimate contact with the patient.

1

A patient receiving long-term antiretroviral therapy (ART) for HIV has developed lipodystrophy, hyperlipidemia, insulin resistance, and bone disease. Which should be the first intervention? 1 Change antiretroviral medications. 2 Promote weight loss through exercise. 3 Advocate use of calcium supplements. 4 Suggest dietary changes to lower lipid levels.

c

A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS) tells the nurse, "I feel obsessed with morbid thoughts about dying." Which response by the nurse is appropriate? a. "Thinking about dying will not improve the course of AIDS." b. "Do you think that taking an antidepressant might be helpful?" c. "Can you tell me more about the thoughts that you are having?" d. "It is important to focus on the good things about your life now."

d

A patient who is human immunodeficiency virus (HIV)-infected has a CD4+ cell count of 400/μL. Which factor is most important for the nurse to determine before the initiation of antiretroviral therapy (ART) for this patient? a. CD4+ cell count trajectory b. HIV genotype and phenotype c. Patient's tolerance for potential medication side effects d. Patient's ability to follow a complex medication regimen

d

A patient with human immunodeficiency virus (HIV) infection has developed Mycobacterium avium complex infection. Which outcome would be appropriate for the nurse to include in the plan of care? a. The patient will be free from injury. b. The patient will receive immunizations. c. The patient will have adequate oxygenation. d. The patient will maintain intact perineal skin.

b

A pregnant woman with asymptomatic chronic human immunodeficiency virus (HIV) infection is seen at the clinic. The patient states, "I am very nervous about making my baby sick." Which information will the nurse include when teaching the patient? a. The antiretroviral medications used to treat HIV infection are teratogenic. b. Most infants born to HIV-positive mothers are not infected with the virus. c. Because it is an early stage of HIV infection, the infant will not contract HIV. d. Her newborn will be born with HIV unless she uses antiretroviral therapy (ART).

a

Eight years after seroconversion, a human immunodeficiency virus (HIV)-infected patient has a CD4+ cell count of 800/μL and an undetectable viral load. What is the priority nursing intervention at this time? a. Encourage adequate nutrition, exercise, and sleep. b. Teach about the side effects of antiretroviral agents. c. Explain opportunistic infections and antibiotic prophylaxis. d. Monitor symptoms of acquired immunodeficiency syndrome (AIDS).

Oral Hairy Leukoplakia

Epstein-Barr white linear patches along lateral border of the tongue

opportunistic infections

Fungal - candidasis of bronchi, trachea, lungs and esophagus , oral does not count Viral - herpes simplex or CMV Protozoal - toxoplasmosis Bacterial - pneumonia , mycobacterium tuberculosis

b

The nurse informs the patient with a bacterial pneumonia that the most important factor in antibiotic treatment is a. antibiotics should have been used to prevent pneumonia. b. all of the supplied antibiotics should be taken even when symptoms have resolved. c. enough antibiotics for 2 days' treatment should be reserved in case symptoms recur. d. patients should request antibiotics for upper respiratory infections to prevent development of streptococcal-related diseases.

c

The nurse is caring for a patient who is human immunodeficiency virus (HIV) positive and taking antiretroviral therapy (ART). Which information is most important for the nurse to address when planning care? a. The patient complains of feeling "constantly tired." b. The patient can't explain the effects of indinavir (Crixivan). c. The patient reports missing some doses of zidovudine (AZT). d. The patient reports having no side effects from the medications.

2

The nurse is preparing to disconnect IV fluid tubing from the access port so the patient can ambulate to the bathroom. What will the nurse wear to prevent the spread of pathogens? 1 A cap 2 Gloves 3 Shoe covers

3

The nurse is reviewing the pathophysiology of human immunodeficiency virus (HIV) infection. Which of these statements about HIV infection is true? 1 HIV is able to replicate outside a living cell. 2 The virus replicates going from DNA to RNA. 3 The immune system is impaired from CD4+ T cell destruction. 4 Infection of monocytes occur, but antibodies quickly destroy these cells.

D

The nurse is teaching a newly diagnosed 34-year-old male about his HIV infection. Which statement by the patient would indicate the patient needs additional education? A. "I will need to take my HIV medication daily for the rest of my life." B. "Although I only take one pill, it has multiple medications combined into a single tablet." C. "I should notify my HIV provider if I get fevers that do not go away with Tylenol or aspirin." D. "Once my viral load is undetectable I don't have to worry about taking my medication every day."

1,3,5

The nurse knows that more patients are developing antibiotic-resistant infections requiring inpatient care. What actions may have contributed to the development of antibiotic-resistant infections? Select all that apply. 1 Prescribing antibiotics for viral infections 2 Performing cultures prior to initiating antibiotic therapy 3 Prescribing inadequate drug regimens to treat infections 4 Prescribing antibiotics based on need rather than patient insistence 5 Prescribing broad-spectrum antibiotics when only first-line antibiotics are needed

b

The nurse palpates enlarged cervical lymph nodes on a patient diagnosed with acute human immunodeficiency virus (HIV) infection. Which action would be appropriate for the nurse to take? a. Instruct the patient to apply ice to the neck. b. Explain to the patient that this is an expected finding. c. Request that an antibiotic be prescribed for the patient. d. Advise the patient that this indicates influenza infection.

d

The nurse will most likely prepare a medication teaching plan about antiretroviral therapy (ART) for which patient? a. Patient who is currently HIV negative but has unprotected sex with multiple partners b. Patient who was infected with HIV 15 years ago and now has a CD4+ count of 840/μL c. HIV-positive patient with a CD4+ count of 160/μL who drinks a fifth of whiskey daily d. Patient who tested positive for HIV 2 years ago and now has cytomegalovirus (CMV) retinitis

2

Which statement would the nurse make when teaching a client with human immunodeficiency virus (HIV) about CD4 T cells? 1 "HIV produces CD4 T cells, which will cause you to have more infections." 2 "HIV destroys your CD4 T cells and depletes your immune system." 3 "Your immune system is considered healthy when you have CD4 T cells." 4 "Immune problems begin when you have more than 500 CD4 T cells/uL."

3

Zoonosis is the spread of disease from animals to humans. Which is a clinical example of a zoonosis infection? 1 Acute meningitis 2 Tuberculosis bacterium (TB) 3 Severe acute respiratory syndrome (SARS) 4 Methicillin-resistant staphylococcus aureus (MRSA)

CD4T less than 200, increased viral load, presence of opportunistic infection or opportunistic cancer, wasting syndrome

aids diagnosis criteria

Protease Inhibitors

inhibits the ability of the virus to reproduce

wasting syndrome

loss of 10% or more of ideal body mass

2,4,5

patient is diagnosed with acquired immunodeficiency syndrome (AIDS). Which opportunistic infections should the nurse monitor for in the patient? Select all that apply. 1 Legionnaires' disease 2 Candidiasis of bronchi 3 Ebola hemorrhagic fever 4 Toxoplasmosis of the brain 5 Mycobacterium avium (MAC) complex

Use condoms, Truvada

preventing transmission of HIV

500

problems occur when CD4T counts drop to less than

vir

protease inhibitors end in

3

What bacteria live in the large intestine and act to protect the body by preventing the overgrowth of other microorganisms? 1 Bile 2 Pathogens 3 Normal flora 4 Clostridium difficile

a

Which information about a patient population would be most useful to help the nurse plan for human immunodeficiency virus (HIV) testing needs? a. Age c. Symptoms b. Lifestyle d. Sexual orientation

e coli, s aureus, strep

common hospital acquired infections

d

Which nursing action will be most useful in assisting a college student to adhere to a newly prescribed antiretroviral therapy (ART) regimen? a. Give the patient detailed information about possible medication side effects. b. Remind the patient of the importance of taking the medications as scheduled. c. Encourage the patient to join a support group for students who are HIV positive. d. Check the patient's class schedule to help decide when the drugs should be taken.

1,3,5

Which of the following are considered mycotic infections? Select all that apply. 1 Thrush 2 Hepatitis C 3 Tinea pedis 4 Tuberculosis 5 Tinea corporis

1

Which patient factor has contributed to the development of antibiotic-resistant superinfections? 1 Skipping doses of antibiotics 2 Finishing the full course of antibiotics 3 Compliance regarding dosing intervals 4 Adherence to prescribed course of treatment

1

for aids crtieria patient must have how many of those indicated

kaposi sarcoma, oral hair leukoplakia, thrush

physical manifestations of HIV

200

CD4T cell amount that allows for opportunistic infections

genotype and phenotype assays

Determines which ART drugs the patient's HIV is sensitive to and which ones is resistant to

flu like

In acute phase of HIV patients experiences what kind of symptoms

Candida albicans

normal flora is also known as

Oropharyngeal candidiasis

official name of thrush

800-1200

normal CD4 count

1,4,5

A nurse educator is teaching a group of nurses how to prevent health care-associated infections (HAI) in hospitals. Which bacteria are common culprits for the spread of health care-associated infections? Select all that apply. 1 Escherichia coli 2 Salmonella typhi 3 Clostridium botulinum 4 Staphylococcus aureus 5 Enterobacter aerogenes

c

A patient treated for human immunodeficiency virus (HIV) infection for 6 years has developed fat redistribution to the trunk with wasting of the arms, legs, and face. What recommendation will the nurse give to the patient? a. Review foods that are higher in protein. b. Teach about the benefits of daily exercise. c. Discuss a change in antiretroviral therapy. d. Talk about treatment with antifungal agents.

d

A patient who has a positive test for human immunodeficiency virus (HIV) antibodies is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP) and a CD4+ T-cell count of less than 200 cells/PL. Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), which statement by the nurse is correct? a. "The patient will develop symptomatic HIV infection within 1 year." b. "The patient meets the criteria for a diagnosis of acute HIV infection." c. "The patient will be diagnosed with asymptomatic chronic HIV infection." d. "The patient has developed acquired immunodeficiency syndrome (AIDS)."

daily, 20, 3

Truvada (tenofovir & emitricabine) Must be taken ________ _____ days to reach maximum effectiveness HCP must be seen every ______ months to evaluate effectiveness

viral load

ART decreases _______ by 90-99%

Lipodystrophy

Abnormality in the metabolism or deposition of fats. Insulin lipodystrophy is the loss of local fat deposits in diabetic patients as a complication of repeated insulin injections.

b,c

According to the Center for Disease Control and Prevention (CDC) guidelines, which personal protective equipment will the nurse put on before assessing a patient who is on contact precautions for Clostridium difficile diarrhea (select all that apply)? a. Mask b. Gown c. Gloves d. Shoe covers e. Eye protection

a

An older adult with chronic human immunodeficiency virus (HIV) infection who takes medications for coronary artery disease and hypertension has chosen to begin early antiretroviral therapy (ART). Which information will the nurse include in patient teaching? a. Many drugs interact with antiretroviral medications. b. HIV infections progress more rapidly in older adults. c. Less frequent CD4+ level monitoring is needed in older adults. d. Hospice care is available for patients with terminal HIV infection.

1

During an assessment, the nurse finds that a patient who is HIV-positive has whitish yellow patches in the mouth, GI tract, and esophagus. Which opportunistic infection is the patient likely experiencing? 1 Candida albicans 2 Coccidioides immitis 3 Cryptosporidium muris 4 Cryptococcus neoforman

2,3

In the early stages of human immunodeficiency virus (HIV) infection, which cells protect the human body from infections? Select all that apply. 1 Platelets 2 T lymphocytes 3 B lymphocytes 4 Red blood cells 5 Immunoglobulins

opportunistic cancers

Invasive cervical cancer Kaposi sarcoma Burkitt's lymphoma Immunoblastic lymphoma Primary lymphoma of the brain

13, 64

The current Centers for Disease Control and Prevention policy is to offer routine testing for HIV to all individuals age ________________.

a,b,e

The nurse plans a presentation for community members about how to decrease the risk for antibiotic-resistant infections. Which information will the nurse include in the teaching plan (select all that apply)? a. Antibiotics may sometimes be prescribed to prevent infection. b. Continue taking antibiotics until all of the prescription is gone. c. Unused antibiotics that are more than a year old should be discarded. d. Antibiotics are effective in treating influenza associated with high fevers. e. Hand washing is effective in preventing many viral and bacterial infections.

c

The nurse prepares to administer the following medications to a hospitalized patient with human immunodeficiency (HIV). Which medication is most important to administer at the scheduled time? a. Nystatin tablet b. Oral acyclovir (Zovirax) c. Oral saquinavir (Invirase) d. Aerosolized pentamidine (NebuPent)

3

The nurse was stuck accidently with a needle used on a patient with human immunodeficiency virus (HIV). After reporting this, what is a priority action by the nurse? 1 A negative evaluation by the manager 2 Applying personal protective equipment 3 Start on combination antiretroviral therapy 4 Begin counseling to report blood exposures

prevents replication, difficult for virus to recover, decreases drug resistance

benefit of combination therapy

25%

without treatment this is the rate of maternal to natal transmission of HIV

decrease viral load, maintain CD4t, prevent opportunistic diseases, delay disease progression, prevent transmission

drug therapy goals for his

HIV antibody test

highly reliable, uses saliva or blood Combination (4th generation tests) can detect HIV up to 3 weeks following infection

immunization, vaccines

how to prevent opportunistic diseases

2

human immunodeficiency virus (HIV)-infected patient is about to receive treatment with antiretroviral drugs. Which statement by the patient reflects a correct understanding of the purpose of these drugs? 1 "Antiretroviral drugs can cure HIV infection." 2 "These drugs work by decreasing the viral load." 3 "Antiretroviral drugs will prevent opportunistic diseases." 4 "These drugs only work in the initial replication stage of the virus."

fungus

mycotic infection is caused by

4

n HIV patient is on long-term antiretroviral therapy (ART). Of what side effects of the antiretroviral therapy should the nurse instruct the patient to be aware? 1 Nausea 2 Vomiting 3 Diarrhea 4 Lipodystrophy

mono therapy, inadequate dose

reasons for resistance

1

A patient with human immunodeficiency virus (HIV) is educated about health promotion activities. What should the nurse inform the patient the importance of these activities is? 1 Delaying disease progression 2 Preventing disease transmission 3 Helping to cure the HIV infection 4 Enabling an increase in self-care activities

d

A young adult female patient who is human immunodeficiency virus (HIV) positive has a new prescription for efavirenz (Sustiva). Which information is most important to include in the medication teaching plan? a. Take this medication on an empty stomach. b. Take this medication with a full glass of water. c. You may have vivid and bizarre dreams as a side effect. d. Continue to use contraception while taking this medication.

a

To evaluate the effectiveness of antiretroviral therapy (ART), which laboratory test result will the nurse review? a. Viral load testing c. Rapid HIV antibody testing b. Enzyme immunoassay d. Immunofluorescence assay

Myobacterium avium

The major manifestation of ___________ is loose, watery stools, which would increase the risk for perineal skin breakdown

3

The nurse assesses a patient with recently diagnosed acquired immunodeficiency syndrome (AIDS). When obtaining a health history from the patient, what statement does the nurse determine most correlates with this diagnosis? 1 "I am feeling fatigue in the evening." 2 "I am sleeping six to eight hours per night." 3 "I have had a steady weight loss over the past several months." 4 "I have been having feelings of helplessness and hopelessness."

c

The nurse designs a program to decrease the incidence of human immunodeficiency virus (HIV) infection in the adolescent and young adult populations. Which information should the nurse assign as the highest priority? a. Methods to prevent perinatal HIV transmission b. Ways to sterilize needles used by injectable drug users c. Prevention of HIV transmission between sexual partners d. Means to prevent transmission through blood transfusions

a

The nurse is advising a clinic patient who was exposed a week ago to human immunodeficiency virus (HIV) through unprotected sexual intercourse. The patient's antigen and antibody test has just been reported as negative for HIV. What instructions should the nurse give to this patient? a. "You will need to be retested in 2 weeks." b. "You do not need to fear infecting others." c. "Since you don't have symptoms and you have had a negative test, you do not have HIV)." d. "We won't know for years if you will develop acquired immunodeficiency syndrome (AIDS)."

a,b,c

The nurse is caring for a patient infected with human immunodeficiency virus (HIV) who has just been diagnosed with asymptomatic chronic HIV infection. Which prophylactic measures will the nurse include in the plan of care (select all that apply)? a. Hepatitis B vaccine b. Pneumococcal vaccine c. Influenza virus vaccine d. Trimethoprim-sulfamethoxazole e. Varicella zoster immune globulin

A

The nurse is caring for a patient who is receiving antiretroviral therapy (ART) for treatment of AIDS. Which assessment best indicates that the patient's condition is improving? A. Decreased viral load B. Increased drug resistance C. Decreased CD4+ T-cell count D. Decreased neutrophil levels

c

Which of these patients who have arrived at the human immunodeficiency virus (HIV) clinic should the nurse assess first? a. Patient whose rapid HIV-antibody test is positive b. Patient whose latest CD4+ count has dropped to 250/μL c. Patient who has had 10 liquid stools in the last 24 hours d. Patient who has nausea from prescribed antiretroviral drugs

pneumonia, TB, candidiasis, herpes, thrush, salmonella

opportunistic diseases seen in HV

Lymphocytes

specific component in blood that indicates HIV

Kaposi sarcoma (KS)

type of skin cancer often seen in patients with AIDS; consists of brownish-purple papules that begin in skin and spread to internal organs

2

A patient has developed West Nile virus after being bitten by a mosquito. What type of infection does the nurse recognize the patient has contracted? 1 Mycotic 2 Emerging 3 Nosocomial 4 Opportunistic

b

The registered nurse (RN) caring for an HIV-positive patient admitted with tuberculosis can delegate which action to unlicensed assistive personnel (UAP)? a. Teach the patient how to dispose of tissues with respiratory secretions. b. Stock the patient's room with the necessary personal protective equipment. c. Interview the patient to obtain the names of family members and close contacts. d. Tell the patient's family members the reason for the use of airborne precautions.

2

A patient is being placed on efavirenz with a once-a-day dose. Which instructions should the nurse give to help the patient cope with the side effects? 1 Use electronic reminders, timers, and beepers. 2 Take the dose at bedtime before going to sleep. 3 Have tests regularly to assess viral load in the body. 4 Inform the health care provider about other drugs being taken.

c

A patient who uses injectable illegal drugs asks the nurse about preventing acquired immunodeficiency syndrome (AIDS). Which response by the nurse is best? a. "Clean drug injection equipment before each use." b. "Ask those who share equipment to be tested for HIV." c. "Consider participating in a needle-exchange program." d. "Avoid sexual intercourse when using injectable drugs."

c

Which patient exposure by the nurse is most likely to require postexposure prophylaxis when the patient's human immunodeficiency virus (HIV) status is unknown? a. Needle stick injury with a suture needle during a surgery b. Splash into the eyes while emptying a bedpan containing stool c. Needle stick with a needle and syringe used for a venipuncture d. Contamination of open skin lesions with patient vaginal secretions

1,2,3

A patient who participates in high-risk activities has undergone an enzyme immunoassay (EIA) test for human immunodeficiency virus (HIV) infection. The nurse reviews the patient's lab results and notes a positive EIA result. What is likely to be included in the patient's plan of care? Select all that apply. 1 Repeat the EIA test. 2 Confirm with a Western blot test. 3 Confirm with an immunofluorescence assay. 4 Confirm with a rapid screening test for antigens. 5 Inform the patient that the patient is HIV-antibody positive.

3

A patient with human immunodeficiency virus (HIV) comes into the clinic with a temperature of 102oF. Which statement would be of most concern to the nurse? 1 "I vomited once this morning." 2 "I woke up this morning with a mild headache." 3 "I have a rash that appeared on my stomach this morning." 4 "I started coughing up some clear mucous when I woke up this morning."